HPV infection can cause health problems for men, too
By Karen Kwan
If you could protect yourself from cancer, would you? Well, last year, Ontario expanded the publicly funded HPV immunization program to include people who are 26 years of age or younger who identify as gay, bisexual, and men who have sex with men, including some trans people. This means they can get a vaccine—free—that can prevent cancers caused by the human papillomavirus (HPV). That’s good news: immunization programs for girls were already in place (initial research uncovered an association between HPV and cervical cancer) and the initiative was expanded to reach boys in Grade 7, but the infection rates of HPV among men are increasing.
HPV is a very common virus with many different strains, some of which can cause cancer. It can be transmitted through skin-to-skin contact, such as anal or oral sex with someone who has the virus. A person could be carrying the virus and never show symptoms, and yet still pass on the virus. These are all factors that make the virus dangerous.
For men, the most common types of cancer caused by HPV include cancer of the penis, and anal and oropharyngeal cancers. Among men who have sex with men, HPV infection and genital warts are three times higher than for heterosexual males, and the rate of anal cancer is 20 times higher. And research shows that 75 per cent of sexually active adults will catch HPV at some point in their lifetime.
Getting the immunization message out is important: if most people get vaccinated, that will lower the transmission of the viral infection, providing “herd immunity,” explains David Brennan, Ontario HIV Treatment Network Research Chair and an associate professor at the University of Toronto. “We know already that once we start vaccinating men, these rates will start to go down, like we have seen happen in places like Australia, where they’ve been vaccinating for HPV for a longer time.”
So the expanded immunization program is a step in the right direction. But that cutoff at 26-year-olds, though? In Brennan’s opinion, it’s not enough. He explains that these are protocols set up in the US, which are partly based on the assumption that people have likely engaged in sexual activity by that ag —but this is not true for all people, he notes.
He adds that for a gay man to get the vaccine by age 26, he has to be willing to come out, which some may not yet be willing to do at that point in their life. Brennan paints the scenario of someone having to go to a public health unit to get the vaccine, which might be hard for someone who hasn’t come out yet. “Gay men have been so disadvantaged by previous policies that, in my opinion, we really need to allow gay men to have access to this vaccine at any point in their lives.”
There are no tests for men for HPV (and keep in mind that you can be exposed with any sexual skin-to-skin contact with any new partner, and that anyone can be infected with HPV many times in their lifetime if they haven’t been vaccinated). Brennan believes that every sexually active person should discuss the vaccine with their healthcare provider to determine whether getting vaccinated makes sense given their own circumstances and sexual behaviours. “Anyone who has had sex with anybody has likely come into contact with HPV,” he says. While he recognizes it’s a bold statement, research does show how pervasive this virus is.
In Brennan’s opinion, if you’re not covered by your provincial plan—if you’re gay and 27 or older in Ontario, for example—then speak to your doctor about your circumstances and any possible complications (although overall the vaccine is very safe and effective). And you’ll also have to consider the $400 to $700 cost.
KAREN KWAN is a freelance health, travel and lifestyle writer based in Toronto. Follow her on Twitter at @healthswellness and on Instagram at @healthandswellness.